Your Full Name
First Name
Last Name
Email #1
*
example@example.com
Email #2
example@example.com
Your Child's Full Name
*
First Name
Last Name
How will your child be getting home after school?
*
Car Rider
JCPRD
South Front Door Walker
Back Door Walker or North Front Walker (All will exit out the back of the building.)
Bus Rider
Daycare Bus Rider
My child will go home multiple ways on a regular basis.
If your child will go home multiple ways, please list their schedule below. For example: MWF Car Rider, TTH Bus Rider
Who does your child live with?
Mother and Father
Father Only
Mother Only
Father and Stepmother
Mother and Stepmother
Mother and Mother
Father and Father
Other
If your child lives in more than one household please share your schedule so that we can accommodate families better. For example: MTW- Mom THF-Dad
How is your child feeling about coming back to school?
This matrix type is not available for legacy form layout.
What are your child's strengths?
What are your child's challenges or what frustrates them?
Please share any additional information about your child or family that may help me meet your child's needs in the classroom.
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